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Please print or type the requested information below to confirm
gala sponsorship.
Name_________________________________________________________
Title _____________________________Council #_____________________
Company/Agency________________________________________________
Address_______________________________________________________
City_____________________________ State_____________
Zip________
Work Phone___________________Home Phone_______________________
Fax ________________________ E-Mail_____________________________
Please indicate choices below:
Diamond Sponsor .......................................$25,000
Platinum Sponsor ...................................... $15,000
Gold Sponsor ............................................. $10,000
Silver Sponsor ............................................ $6,000
Bronze Sponsor .......................................... $3,000
Individual Ticket Please reserve______ticket(s) at $250 per ticket
LULAC Members Please reserve______ticket(s) at $100 per ticket
Enclosed is my check, payable to LULAC Legislative Gala in the
amount of $________________
Please charge my:
Visa
Mastercard
American Express
Account No:_____________________________Exp Date ______________
Signature:_______________________________Date__________________
Please send agreement and payment to:
LULAC National Office
2000 L Street NW, Suite 610
Washington,
DC 20036
(202) 833-6130 · Fax (202) 833-6135 ·
www.LULAC.org · ERomo@LULAC.org
Contributions to the legislative gala are
not tax deductible as a charitable
contribution but may be deductible as a
business expense
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